HomeMy WebLinkAbout17-19045 CITY OF ZEPHYRHILLS
` � 5335-8TH STREEI'
(813)780-0020 . 190
BUILiDTNG PERMIT
' PERiViIT INFORMATION • - LOCATION INFORMATION
Permit Number: 19045 Address: 37340 DERBYSNIRE DR
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Glass of Work: R!C CHANGEOUT Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: WEDGEWOOD MANOR
Est. Val+ue: Parcel Number: 10-26-21-0120-00{}00-0950
Improv. Cost: 4,941.00 OWNER INFORMATIQN
Date Issued: 11113120T7 Name: FERDINAND4 �EONCE &ALVAREZ PAT
Total Fees: 60.00 Address: PO BOX 1299
Amount Paid: 60.40 ZEPNYRHILLS, FL. 33539-1299
Date Paid: 11/13/2017 Phone: (813 779-3700
Work Desc: A!C CHANGE OUT 3.5 TON 14 SEER
CONTRACTOR S APPLICATION FEES
SENICA AIR CONDITIONING INC A/C CHANGEOUT 60.00
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Ins ections e uired
DU TS IN TALL
DUCTSItJ5ULATED
FINAL
REINSPECT'ION FEES: (c)With respect ta Reinspection fees will compiy with Florida Statute 553.80 (2)(c)the
loca(governmenfi shall impose a fee of four times the amount of the fee imposet!for the initiai inspection ar
first reinspection,whichever is greater,far each such subsequent reinspection.
NOTICE: In addition to the requirements of this permit, there maybe additional restrictions applicable to this property that
may 6e faund in the pubiic records of this county, and there may 6e additianal permits required fram other governmental
entities such as water management, state agencies or federal agencies.
"Warning to owner: Yaur fai[ure to record a natice af commencement may result in your paying twice far
impravements to your property. If you intend to abtain financing, consult wifih your lender ar an attorney
before recording your natice of commencement."
Complete Plans,Specificatians Must Accompany Applica#ion. Atl wark shall be pertormed in accordance with
Ci Codes and Ordinances. NO OCCUPANCY BEFORE CA.
NCI OCCUPANCY BEFt3RE C.O.
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CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN fi MONTHS VYITHC�UT APPR4VED INSPE�'t'ION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PRCfTECT CARD FRBM WEATHER .
� 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Deparlment
Date Received Phone Contact for Pertnittin —
Owner's Name �I��f�IV�1F�Q0 ���Ce r �' /ifGGKCz lG /G Owner Phone Number ���' / ! 'J �'�f
Owner's Address Q �Q��� � ��3 .CJ.3 .� Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS � � Q C� S �RC � L . //!3 J�S'TI� LOT# �
SUBDIVISION G G!/Qd �� PARCELID# �D'c►�u���'Q���'Q�00�' Q �0
(OBTAINED FROM PROPERTY TAX N0710E)
WORK PROPOSED NEW CONSTR ADD/ALT � SIGN � � DEMOLISH
B INSTALL B REPAIR
PROPOSED USE � SFR Q COMM � OTHER
TYPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL �
DESCRIPTION OF WORK � • e ��/�� � .�ee�e �t.���Fy� F.B�I!�d� ��
BUILDING SIZE SQ FOOTAGE� HEIGHT
�BUILDING $ VALUATION OF TOTAL CONSTRUCTION
�ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY � W.R.E.C.
�PLUMBING $
�MECHANICAL $ �/� � VALUATION OF MECHANICAL INSTALLATION � v�S
9`a' �
�GAS Q ROOFING Q SPECIALTY � OTHER
FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA �YES NO '
�'�� � u �—i isv� i i s i i e a i i�i�i�i-�i���{�� �
BUILDER COMPANY
SIGMATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address
License#
PLUIVIBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address License#
MECHANICAL `Z��"LLc �i2� COAfIPANY QN�G"/f �I� G�(/ / DN//V �,U�
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
� Address ��` ,� � � /�1 ' //e///ir /7'/�/ License# �� ��S
�� ����
OTHER COMPANY �
SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
Address
License#
B 9 S A 1 1 1 1 1 ! A 1 1 1 L 1 1 A 1 1 1 1 ! 1 1 1 0 0 1 � @ 1"1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction,
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/5ilt Fence installed,
Sanitary Facilities 8�1 dumpster;Site Work Permit for subdlvisions/large projects
COMMERCI,4L Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
- Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance
SIGfd PERMIT Attach(2)sets of Engineered Plans. ` • ,
**"PROPERTY SURVEY required for all NEW construction.
..a.�.,��s..s..s�; �. o .�,.��• e.�..�:_e_a..o_�� � a s z a � ��.�..e..�� � . . : .� •Y,,,,:_■ •..-.:......_• • ^
Dlrections:
Fill out application completely
Owner&Contractor sign back of application,notarized �
If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) - ,
"`" Agent(for the contractor)or Power of Attomey(for the_owner)would be someone with notarized letter from owner authorizing same
OVEI2 THE COUNTER PERMITTING (Front of Application Only) '
Reroofs if shingies Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) ,
Driveways-Not over Counter if on public roadways..needs ROW
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fdt7TlCE{3F ��ED R�STRICTIONS: The undersigned undersfands that this permit may be subject to"deed"restrictians°
which may be more restrictive than County regulations. The undersigned assumes respansibility for compliance with any
applicable deed restrictions. - � . .
UNLICENSE� CONTl�ACTORS ARtD CQNTRACTOR R�SPONSt�ILITtE$: If the owner tias�hired "a contractor or
contractors to undertake work, they.may be requireci to.be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the ouvne��and contractor may be`cited for a ri�isdemeanor violation
under sfate (aw. lf fhe owner or intended contractor are uncertain as to what licensing requiremen#s�may app(y for the
intended work, they are advised to contac#the Pasco County Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contrackor or contrac#ars, he is advised to have the contracto�{s) sign
porkions of the '"contractor Block" of this application for which they will be responsible. If you, as the owner sign as the
cantractor, that may be an indicatian that he-is not praperly licensed and is not entitled ta permitting privi{eges in Pasco
County. � - - � . . , . .
TFtANSPC7RTATION IMPACT/UTIL[TIES Ii1�PAC'�AND RESOl1RCE RECOVERY FEIES: The undersigned understands
that Transpoctation lmpact Fees and Recaurse Recovery Fees may apply tr�the cons#ruction of new buildings, change of
use in existing buildings, or expansian of existing buildings, as specified in Pascb County Ordinance number 89-07 and
90-07, as amended. The undersigned alsa understands, that such fees, as may be due,.will be identified at the time of '
permitfing. lt is further understood that Transportation Impac# Fees and Resource Recovery Fees rnust be paid priar ta
receiving a "ceRificate of occupancy"' or final power release. If the project does not invalve a certificate of occupancy or
fina! power release, the#ess must be paid prior ta permit issuance. Furthe�more, if Pasca County WaterlSewer Impact
fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco Caunty ardinances.
CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes, as amended): If valuation of worK is$2,50p.00 or more, !
certify that 1, the applicarit,"have been provided vuith a°copy af the "Florida Construction �ien Law—Hameawner's
Pratection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the"awner", I certify that 1 have abtained a copy of the abave described documen#and prarr►ise in gaod faith ta
de{iver it to the`bwner"prior#o commencement. ,
CONTRA,CTOR'S/OWNER'S AFFiD�►VIT: I certify that all the information in this application is accurate and that all work
wi11 be done in compliance with all applicable laws regulating canstruction, zoning and land deveiopment. AppEication is
hereby made to obtain a permit to do work and installation as indicated. I certify that no worlc or ins#allation has
commenced prior to issuance of a permit and that all uvork will be performed to meet standards of all laws regt�lating
construc#ion, County and City codes, zoning regvlatians, and land develapment reguiations in the jurisdicfion. i aiso
certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is
my responsibility to identify what actions 1 must take to be in campliance. Such agencies include buf are not Eimited to:
- Departmen# of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,Wa#erMlastewater Treatmen#. �
- Sauthwest Florida Water Management t7istrict-Wells, Cypress Bayheads, Wetland Areas, .Alfering
Watercourses.
- Army Corps af Engineers-Seawalls, Docks, Navigable Waterways_
- Department of Health & Rehabilitative Services/Enviranmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
- US E�vironmental Protecfion Agency-Asbestos abatement.
- Federal Aviation Authority-Runways.
! understand that the follawing restrictions apply to the use of filL• �
- Use of fili is not ailowed in Fload Zone"V"unless expressly permitted.
- If the fill material is ta be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume" will be submitted at time of permiiting which is prepared by a professional engineer
licensed by the Sta#e of Floricla.
- !f the fill materia! is to be used in Flood Zone "A'" in connection with a perrriitted huilding using stem waN
cons#ructian, !certify tha#fl(wil(be used only to fll the area within the stem wall.
- If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fiif is found ta adversefy afFect adjacent prope�ties, the owner may be cited for violating .
fhe conditians of the building permit issued under the at#ached permit application, for lots less than,one (1)
acre which are elevated by fill, an engineered drainage plan is required. .
If i am fhe AGEPlT FOR'�HE t�WNEFt, 1 pramise in gaod faith to inform the owner of the permitting conditions set fprth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wefls, pools, air conditioning, gas, or other installations nof specifically included in the application. A
permit issued shal( be construed to be a license ta proceed with the work and not as au#hority to violate, cancel, alter, or
set aside any provisions of the technical cades, nor shall issuance of a permit prevent the Building Official from thereafter .
requiring a correction of errors in plans, cor2stcuction or violatiarrs af any codes. Every permit issued shal!beeome invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandonsd for a period of six(6) months after the time the worlc is commertced. An extension
may be requested, in writing, from the 8uiiding Officiai far a period not to exceed ninety (90} days and will demonstrate
justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned.
� WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT !N YOUR
PAYING TWICE FOR IMPROVEMENTS TC?YOUR PROPER'fY. IF YOU lNTENCD 70 OBTAfN FINAl�CIAIG,COIVSULT
WiTFi Yfl�IR LE�iDER OR ARt ATTQRNEY�EF€�RE R�CORDfNG YOUR NOTIGE OF CtJMfldiENCE1V�Et�i'.
FLORIDA JURAT(F.S. 17.03) � �„y — _'
--QWI�IEt2 0R AG ElV-T- —-- -� —.-_ -— -- _ ' —__• _.__£;8ist-Tf2ACT_�R--- - -_._ �3'"i'�!�T�?��=__"_—=-...T-..:�
Subscribed and swom t r ffi )be��//���- Subscribed and sworn to affirme efo� e is �`
bY by G�.:�'-if/
Wh�istars personallv knawn fo me or has have B aduced 1N„�'�slare persanall known e ar haslhave produced
as identificatian. as ide�tification.
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� �-� '"���"'""�Nota Public d'�4,��/ ` _'
rY �"""�� Notary Public
Gommission No. Commission No. 1"�_7_ �'7f
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Name af Notary typed,printed or stamped Name of'Notary typed,printed ar stamped
4 O;�jgY P�, pATR3GIA M4DERSON 'Y'6�• PATRIGIA AhDEftS4N
:r,• 'o', �^a-•y;:'�,
:,: ,,: MY CONI�ISSIQN#FF 834900 :`�' "= MY CONNIS510N#FF 934900
=;; 4' EXPIRES:Jaruary 3,2020 ;�•., 4= EXPIRE ary 3,2020
�; ��'.. S:Janu
'_'�'„'r t�. Bonded Thru Notary Pu6fic Underreriters �.�a;.�k''�' Batrc'ed'fhN Notary Pabtic UnderwriEes�
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AI�R�-���CO�IDITIONI�NG��� ���
Hernando Pasco Citrus Hillsborough Pinellas
(352) 686-6166 (727) 856-0058 (352) 795-9685 (813) 995-0505 (727) 799-1300
Statewide (800) 897-2335
November 13, 2017
City of Zephyrhills
Zephyrhills, FL
Please accept this letter as authorization for Mark Sittig (Drivers License #S320-547-
56-349-0) to act as my agent for Senica Air Conditioning, Inc.
If any additional information is needed or if there are any questions, please contact
my office at 727-856-0058.
Regards,
��'���'`"'— ��
li Mark Nelson
License #CAC1815564
State of Florida
County of Pasco
Sworn to and subscribed before me this 20th day of April 2017,
by Mark Nelson, who is personally known to me.
Ya�s+�>y�c i PATRICIA ANDERSON
;,; ,- MY COMMISSION k FF 934900
=�..�.P; EXPIRES:January 3,2020
�� ��°��F�'`�� Bonded Thru Notary Public Undernriters
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Notary Public Print Name or Seal
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and equipment are warr�rrted by the TC�p�.SUMMAqy
T��� manufacturers' or suppliers' written warranty
oniy.AU tabor perfarmed hy tne above r+amed 707'AL �
company i9 w3,rv'8nt9d for 30 da}�s oP as JviATERtA1„$
otherwise indfcated in wrtting,The abov�named 07AL J
eempany makgs no othar warranties,express OR
i navo authonry�o order Ihe wortc outlinod abow which hss baon.^•.a.laetony r,�npWi9C,�npne thes p��m�I IEt�, and Its agents vr technleians ar
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wid mmoval�aH not be Ihc mppqn!uppky pt Sgppr, v y
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